#AHPs are one of the latest twists in the ever changing Group Health Insurance landscape for #employers. AHPs will be coming as soon as September and the offerings are not set in stone. The Association Health Plans can have various ways of setting prices on industries, ages, even gender. One of the selling points to AHPs are that they can be offered by insurance companies out of CA, increasing competition between the carriers. Some of the embedded #GroupBenefits will be carried over from the #ACA into the AHPs.
Association Health Plan membership is changed drastically with Trump’s ruling
With previous AHPs, the member groups had to share a common industry or some other economic nexus. The new ruling allows AHP members to be connected by business, professional interests, or even simply geography. The new AHPs can even be formed with the sole intent of providing insurance to their members. Members can be small businesses, larger businesses or even individuals. AHPs will still be required to allow members to cover their kids until age 26, and they can’t discriminate against individuals with pre-existing conditions. These folks may have higher premiums, but coverage will not be denied.
Differences with the new AHPs
The new AHPs don’t HAVE to include the 10 essential health benefits that the ACA was built on, but my suspicion is that most of them will have most of these benefits. AHPs that cover #employees with at least 15 employees, must offer maternity coverage. That means “offer”….not necessarily be mandated to have embedded in the plans, like now. The new plans will have the yearly maximums that ACA plans have currently. That is a good thing, although having plans with much higher yearly maximums, in earlier years, were WAY less expensive. An interesting option if it was allowed to be offered now.
Companies with over 50 employees and the #EmployerMandate
Applicable Large Employers, or #ALEs, will still be required to offer health insurance that meets the minimum standards set by the ACA, back in 2010, or face harsh penalties. Currently, ALE employers cannot allow employees to pay more than 9.5% of their gross wages for the single employee monthly premium, to stay compliant. Many employers are being audited by the IRS now, for non compliance in the 2015 tax year. They are getting big scary letters with penalties and assessments from the IRS. Nothing you want to mess with.
Overall, the onset of the new AHPs may be a good thing. Too hard to tell just yet. Either way, Group Benefit Brokers are needed even more, to translate all of this nonsense, so business people can spend their time running their business. What may happen is that insurance brokers that are not specialists, may be squeezed out of the market, for lack of #ACA understanding.
Steve Brauer, Brauer Insurance Services LLC. Call us to get the scoop on the ACA…with NO expectation of doing business. www.brauerinsurance.com (877) 421-4325